The efficacy of rapid palatal expansion on the eruption of impacted maxillary canine: a systematic review

Abstract Objective The purpose of this study was to assess the current literature on the effectiveness of rapid palatal expansion (RPE) in assisting the spontaneous eruption of impacted maxillary canines. Materials and methods Four electronic databases were searched (Pubmed, Scopus, Web of Science, Embase) by applying appropriate Medical Subject Headings (MeSH). Two authors independently and systematically reviewed the literature. Randomised controlled trials (RCTs) and prospective controlled clinical trials (pCCTs) were identified and selected. The Cochrane Collaboration’s risk of bias tool and the risk of bias in non-randomised studies of interventions (ROBINS-I) were used to assess the quality of the obtained articles. Spontaneous canine eruption was used as a primary outcome. Results Three RCTs and two pCCTs met the inclusion criteria. One study was assessed at a high risk of bias in the RCT group, while the remainder were at an unclear risk of bias. Both pCCTs were classified as a moderate risk of bias based on the ROBINS-I tool. The success rate of canine eruption following RPE, with or without additional treatment, ranged from 65.7 to 85.7%, which was statistically significantly different from the control group. Conclusion RPE appears to improve the position of displaced maxillary canines and increase the likelihood of spontaneous eruption. However, there is a shortage of high-quality evidence to conclude that RPE can be an effective treatment option for impacted maxillary canines.